Chronic critical limb ischemia remains one of the most frequent causes of illness and hospitalization in the western world. Interest in critical limb ischemia has increased markedly in recent years. There have been significant achievements in diagnostic pro cedures as well as in the medical, invasive, and surgical treatment of patients with critical limb ischemia. Despite a considerable research effort, the pathophysiological mechanisms of critical limb ischemia in humans remains to be established. Prominent is the increasing interest in the microcirculation, as well as in the hemorheological, hemostatic and inflammatory changes which may promote critical limb ischemia. Further research is necessary to quantify the relevance of microcirculatory in vestigations in terms of predicting the prognosis or to evaluate the effects of new therapies. Our main task is to offer the patient the best possible therapy in order to avoid limb loss and to improve quality of life. The various methods of treatment, their suc cess rates, and their complications, must be carefully evaluated and discussed. This volume presents the complex field of diagnosis and treatment of critical limb ischemia. The diagnosis and treatment involves different specialists including angio logists, interventional radiologists, vascular surgeons, plastic surgeons, diabeto logists, etc. Individual chapters have been written by Belgian and German experts in the various specialities, who present their own experience. We are very grateful that these experts have joined us to produce this book on the epidemiology, pathophysiology, and rational therapy.
Sprache
Verlagsort
Illustrationen
46
46 s/w Abbildungen
X, 240 p. 46 illus.
Dateigröße
ISBN-13
978-3-642-72515-9 (9783642725159)
DOI
10.1007/978-3-642-72515-9
Schweitzer Klassifikation
Epidemiology of critical limb ischemia.- Definition, incidence and epidemiology of critical limb ischemia.- Natural history and evolution of peripheral arterial disease.- Patient prognosis with critical limb ischemia: an update of 164 patients.- Conservative management of critical limb ischemia.- Investigation and management of patients with chronic critical limb ischemia due to peripheral arterial occlusive disease.- The role of Prostaglandin E1 in patients with critical leg ischemia.- Antithrombotic therapy in chronic leg arterial disease.- Hemodilution in patients with peripheral obstructive arterial disease.- Assessment of microcirculation.- Assessment of the microcirculation by videocapillaroscopy in patients with critical limb ischemia.- Angioplasty.- Percutaneous transluminal angioplasty for crural obliterations.- Complications during and after percutaneous transluminal angioplasty (PTA) of iliac and peripheral arteries.- Efficacy and tolerance of recombinant tissue-type plasminogen activator in patients with thrombotic or embolic occlusion of leg-arteries.- Angioplasty and combined procedures.- Below-knee excimer laser angioplasty associated with femoropopliteal bypass grafting.- Single-stage angioplasty and vascular reconstruction.- Combined endoluminal and surgical vascular reconstructions.- Simultaneous endovascular procedures in chronic and acute ischemia.- Bilateral critical limb ischemia in the elderly high-risk patient: an alternative for aortobifemoral bypass: combination of iliac artery intravascular stent with femoro-femoral cross-over bypass.- Distal reconstruction.- Bypasses to isolated popliteal artery.- Principles of infragenicular vascular reconstruction in patients with critical limb ischemia.- In situ vein bypass for critical limb ischemia.- Results of pedal and plantar reconstruction.- Critical limb ischemia - does the limb salvage rate justify the time-consuming reconstruction of pedal arteries?.- Venous allografts for critical limb ischemia.- Cryopreserved homologous saphenous veins in femorodistal arterial reconstructions.- Femorodistal reconstruction with the PTFE graft.- Surveillance of infrainguinal arterial reconstructions: importance of duplex-derived peak systolic velocity and ankle brachial index in femorodistal graft assessment.- Homologous vein grafts in femoropopliteal reconstruction: an over 10-year experience.- Surgical strategy after failed peripheral bypass surgery.- Local thrombolysis for occluded arterial grafts: Is the yield worth the effort?.- Plastic reconstructive surgery in patients with end-stage peripheral arterial disease.- Management of the diabetic foot.- Amputation in the dysvascular patient: techniques and levels.- Epidural spinal cord stimulation in the treatment of non-reconstructible peripheral occlusive disease (PAOD).
